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Case Reports
. 2023 Nov 21;22(6):164.
doi: 10.31083/j.jin2206164.

Transcranial Magnetic Stimulation for the Treatment of Gambling Disorder: A Systematic Review

Carmen Concerto  1 , Maria Salvina Signorelli  1 , Cecilia Chiarenza  1 , Alessia Ciancio  1 , Antonio Di Francesco  1 , Ludovico Mineo  1 , Alessandro Rodolico  1 , Giulia Torrisi  1 , Pasquale Caponnetto  2   3 , Manuela Pennisi  4 , Giuseppe Lanza  5   6 , Antonino Petralia  1
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Free article
Case Reports

Transcranial Magnetic Stimulation for the Treatment of Gambling Disorder: A Systematic Review

Carmen Concerto et al. J Integr Neurosci. .
Free article

Abstract

Background: Gambling Disorder (GD) is a behavioral addiction listed within the diagnostic category of substance-related and addictive disorders. Recently, transcranial magnetic stimulation (TMS), which non-invasively stimulates the brain and has neuromodulatory properties, has emerged as an innovative treatment tool for GD, thus offering a new option for the management of this complex disorder. The present review explored the efficacy of TMS as a possible non-pharmacological treatment for GD.

Methods: An exhaustive search was performed across the MEDLINE, Web of Science, and EMBASE databases using a specific search string related to GD and TMS. A total of 20 papers were selected for full-text examination, out of which eight fulfilled the inclusion criteria and were therefore systematically analyzed in the present review.

Results: This review included eight studies: three randomized-controlled trials (RCTs), three non-controlled studies, one case series, and one case report. Two cross-over RCTs described a decrease in craving after high-frequency (excitatory), repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) and the medial prefrontal cortex (PFC), respectively; another study applying low-frequency (inhibitory) rTMS on the right DLPFC did not find any positive effect on craving. Among uncontrolled studies, one demonstrated the beneficial effect of high-frequency rTMS over the left DLPFC, while another showed the efficacy of a continuous theta burst stimulation protocol directed over the pre-supplementary motor area, bilaterally.

Conclusion: The included studies showed the promising effect of excitatory stimulation over the left PFC. However, further investigation is needed, particularly in terms of standardizing stimulation protocols and psychometric assessments.

Keywords: craving 2; gambling disorder 1; repetitive transcranial magnetic stimulation 3; theta burst stimulation 4.

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Conflict of interest statement

The authors declare no conflict of interest. Carmen Concerto is serving as one of the Guest editors of this journal. Giuseppe Lanza is as serving as one of the Editorial Board member of this journal. We declare that Carmen Concerto and Giuseppe Lanza had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to Gernot Riedel.

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